Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes

Jassim Al Suwaidi, Donal N. Reddan, Kathryn Williams, Karen S. Pieper, Robert A. Harrington, Robert M. Califf, Christopher B. Granger, E. Magnus Ohman, David Holmes

Research output: Contribution to journalArticle

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Abstract

Background - Outcomes in patients with mild to moderate renal function (RF) abnormalities presenting with acute coronary syndromes (ACS) are not well defined. Methods and Results - A convenience sample of 4 ACS trial databases including all enrolled patients was assessed to determine 30- and 180-day outcomes, The 4 trials were Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIb, GUSTO-III, Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT), and Platelet IIb/IIIa Antagonism for the Reduction of Acute coronary syndrome events in a Global Organization Network (PARAGON-A). Patients were stratified into ST-segment elevation (STE) and non-ST-segment elevation (NSE) groups and by the presence or absence of abnormal RF (creatinine clearance <70 mL/min). In the STE group, 7670 of 18 621 patients (41%) had abnormal RF. In the NSE group, 8152 of 19 304 (42%) had abnormal RF. Patients with abnormal RF were older, more often female, and more likely to have adverse baseline characteristics. They had higher mortality and higher mortality/nonfatal myocardial infarction (MI) at both 30 and 180 days, regardless of ST-segment status. Creatinine clearance was independently associated with risk of mortality (hazard ratio 0.79 in the STE group and 0.81 in the NSE group) and with risk of mortality/MI (hazard ratio 0.93) in the NSE group at 180 days. Conclusions - Patients presenting with ACS frequently have abnormal RF. Abnormal RF is a marker of adverse baseline clinical characteristics and is independently associated with increased risk of death and death/MI.

Original languageEnglish (US)
Pages (from-to)974-980
Number of pages7
JournalCirculation
Volume106
Issue number8
DOIs
StatePublished - Aug 20 2002

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Acute Coronary Syndrome
Kidney
Mortality
Myocardial Infarction
Creatinine
Integrin beta3
Platelet Glycoprotein GPIIb-IIIa Complex
Unstable Angina
Coronary Vessels
Blood Platelets
Organizations
Databases

Keywords

  • Coronary disease
  • Kidney
  • Mortality
  • Myocardial infarction
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Al Suwaidi, J., Reddan, D. N., Williams, K., Pieper, K. S., Harrington, R. A., Califf, R. M., ... Holmes, D. (2002). Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes. Circulation, 106(8), 974-980. https://doi.org/10.1161/01.CIR.0000027560.41358.B3

Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes. / Al Suwaidi, Jassim; Reddan, Donal N.; Williams, Kathryn; Pieper, Karen S.; Harrington, Robert A.; Califf, Robert M.; Granger, Christopher B.; Ohman, E. Magnus; Holmes, David.

In: Circulation, Vol. 106, No. 8, 20.08.2002, p. 974-980.

Research output: Contribution to journalArticle

Al Suwaidi, J, Reddan, DN, Williams, K, Pieper, KS, Harrington, RA, Califf, RM, Granger, CB, Ohman, EM & Holmes, D 2002, 'Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes', Circulation, vol. 106, no. 8, pp. 974-980. https://doi.org/10.1161/01.CIR.0000027560.41358.B3
Al Suwaidi J, Reddan DN, Williams K, Pieper KS, Harrington RA, Califf RM et al. Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes. Circulation. 2002 Aug 20;106(8):974-980. https://doi.org/10.1161/01.CIR.0000027560.41358.B3
Al Suwaidi, Jassim ; Reddan, Donal N. ; Williams, Kathryn ; Pieper, Karen S. ; Harrington, Robert A. ; Califf, Robert M. ; Granger, Christopher B. ; Ohman, E. Magnus ; Holmes, David. / Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes. In: Circulation. 2002 ; Vol. 106, No. 8. pp. 974-980.
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abstract = "Background - Outcomes in patients with mild to moderate renal function (RF) abnormalities presenting with acute coronary syndromes (ACS) are not well defined. Methods and Results - A convenience sample of 4 ACS trial databases including all enrolled patients was assessed to determine 30- and 180-day outcomes, The 4 trials were Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIb, GUSTO-III, Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT), and Platelet IIb/IIIa Antagonism for the Reduction of Acute coronary syndrome events in a Global Organization Network (PARAGON-A). Patients were stratified into ST-segment elevation (STE) and non-ST-segment elevation (NSE) groups and by the presence or absence of abnormal RF (creatinine clearance <70 mL/min). In the STE group, 7670 of 18 621 patients (41{\%}) had abnormal RF. In the NSE group, 8152 of 19 304 (42{\%}) had abnormal RF. Patients with abnormal RF were older, more often female, and more likely to have adverse baseline characteristics. They had higher mortality and higher mortality/nonfatal myocardial infarction (MI) at both 30 and 180 days, regardless of ST-segment status. Creatinine clearance was independently associated with risk of mortality (hazard ratio 0.79 in the STE group and 0.81 in the NSE group) and with risk of mortality/MI (hazard ratio 0.93) in the NSE group at 180 days. Conclusions - Patients presenting with ACS frequently have abnormal RF. Abnormal RF is a marker of adverse baseline clinical characteristics and is independently associated with increased risk of death and death/MI.",
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T1 - Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes

AU - Al Suwaidi, Jassim

AU - Reddan, Donal N.

AU - Williams, Kathryn

AU - Pieper, Karen S.

AU - Harrington, Robert A.

AU - Califf, Robert M.

AU - Granger, Christopher B.

AU - Ohman, E. Magnus

AU - Holmes, David

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N2 - Background - Outcomes in patients with mild to moderate renal function (RF) abnormalities presenting with acute coronary syndromes (ACS) are not well defined. Methods and Results - A convenience sample of 4 ACS trial databases including all enrolled patients was assessed to determine 30- and 180-day outcomes, The 4 trials were Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIb, GUSTO-III, Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT), and Platelet IIb/IIIa Antagonism for the Reduction of Acute coronary syndrome events in a Global Organization Network (PARAGON-A). Patients were stratified into ST-segment elevation (STE) and non-ST-segment elevation (NSE) groups and by the presence or absence of abnormal RF (creatinine clearance <70 mL/min). In the STE group, 7670 of 18 621 patients (41%) had abnormal RF. In the NSE group, 8152 of 19 304 (42%) had abnormal RF. Patients with abnormal RF were older, more often female, and more likely to have adverse baseline characteristics. They had higher mortality and higher mortality/nonfatal myocardial infarction (MI) at both 30 and 180 days, regardless of ST-segment status. Creatinine clearance was independently associated with risk of mortality (hazard ratio 0.79 in the STE group and 0.81 in the NSE group) and with risk of mortality/MI (hazard ratio 0.93) in the NSE group at 180 days. Conclusions - Patients presenting with ACS frequently have abnormal RF. Abnormal RF is a marker of adverse baseline clinical characteristics and is independently associated with increased risk of death and death/MI.

AB - Background - Outcomes in patients with mild to moderate renal function (RF) abnormalities presenting with acute coronary syndromes (ACS) are not well defined. Methods and Results - A convenience sample of 4 ACS trial databases including all enrolled patients was assessed to determine 30- and 180-day outcomes, The 4 trials were Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIb, GUSTO-III, Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT), and Platelet IIb/IIIa Antagonism for the Reduction of Acute coronary syndrome events in a Global Organization Network (PARAGON-A). Patients were stratified into ST-segment elevation (STE) and non-ST-segment elevation (NSE) groups and by the presence or absence of abnormal RF (creatinine clearance <70 mL/min). In the STE group, 7670 of 18 621 patients (41%) had abnormal RF. In the NSE group, 8152 of 19 304 (42%) had abnormal RF. Patients with abnormal RF were older, more often female, and more likely to have adverse baseline characteristics. They had higher mortality and higher mortality/nonfatal myocardial infarction (MI) at both 30 and 180 days, regardless of ST-segment status. Creatinine clearance was independently associated with risk of mortality (hazard ratio 0.79 in the STE group and 0.81 in the NSE group) and with risk of mortality/MI (hazard ratio 0.93) in the NSE group at 180 days. Conclusions - Patients presenting with ACS frequently have abnormal RF. Abnormal RF is a marker of adverse baseline clinical characteristics and is independently associated with increased risk of death and death/MI.

KW - Coronary disease

KW - Kidney

KW - Mortality

KW - Myocardial infarction

KW - Prognosis

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